BACKGROUND: Sulfonylurea is recommended to be taken before meal. But since premeal administration is against Koreans usual medication habit, it can be the cause of poor compliance. Such recommendation is based on the results of a few clinical trials about appropriate medication time. But most of the clinical studies had a limitation : observe only acute effects of medication, subjects were only healthy volunteer. So the chronic effect of sulfonylurea of each kind must be validated. METHODS: From 1996 May to 1996 July, data were collected from diabetic patients who visited an university hospitals for managing diabetes and used a intermediate-acting sulfonylurea. The subjects were randomized to two groups of premeal group and postmeal group, by chart number and were asked to take the previous medicine according to assignment. After 1 month medication, mixed meal tolerance test was done with 300Kcal carbohydrate, 400+/-50Kcal diet. The subjects were switched to the other group and 2nd mixed meal tolerance test was done 1 month later. The Area under curves was calculated in preand post-prandial glucose curve and was compared by paired t-test. RESULTS: During the study period, total 16 diabetic patients were enrolled. There was no significant statistical difference between pre-prandial group and post prandial group in AUC. CONCLUSIONS: Intermediate-acting sulfonylurea can be administered at any time in relation to meaL.
Area Under Curve ; Compliance ; Diet ; Eating* ; Glucose ; Healthy Volunteers ; Hospitals, University ; Humans ; Meals

Among the skeletal tuberculous spondylitis is high incidence and curable disease, if early diagnosis and treatment are possible. We reviewed clinical manifestations and radiologic analysis of 30 cases tuberculous spondylitis from May 1983 to Sept. 1986, at Yeungnam medical center, Yeungnam University. The results were follows: 1. The frequent involve sites were thoracolumbar vertebra. 2. The continuous lesion is 86.7% of the all cases. 3. The most common type was intervertebral type, and lytic and sclerotic lesion were same incidence. 4. Paravertebral abscess, kyphosis and disc space narrowing were demonstrated more than 80.0% of the cases. 5. Computed tomography was more accurate diagnostic method rather than conventional plain study to evaluation of extent of lesion, involvement of spinal canal and cord, and size and location of paravertebral abscess. And CT guided abscess drainage procedure was helpful to diagnosis and treatment. 6. Ultrasonography was helpful to differential diagnosis between paravertebral abscess and other solid mass, and useful to follow up study of paravertebral abscess after treatment.
Abscess ; Diagnosis ; Diagnosis, Differential ; Drainage ; Early Diagnosis ; Follow-Up Studies ; Incidence ; Kyphosis ; Methods ; Spinal Canal ; Spine ; Spondylitis* ; Ultrasonography

Allergic contact dermatitis is a prototype of delayed hypersensitivity reaction. Langerhans cells, keratinocytes and T lyrnphocytes play major roles in the pathogenesis of allergic contact dermatitis. We observed Langerhans cells and keratinocytes in contact sensitized epidermal sheets of mice and performed mixed epidermal cell lymphocytes reaction with normal epidermal cells and contact sensitized epidermal cells to determine the lymphocyte stimulating capacity of contact sensitized epidermal cell. We obtained following results : 1. The Langerhans cells were decreased in number and morphologically damaged in contact sensitized epidermis. 2. Ia antigen expression on keratinocytes was detected in almost all contact sensitized epidermal sheets. 3. The allogeneic lymphocyte stimulating capacity of contact sensitized epidermal cells was greater than that of normal epidermal cells. 4. The allogeneic lymphocyte stimulating capacity of contact sensitized epiderrnal cells was lost after treatment of epidermal cells with anti Ia antibody and complement. From these results, it is conceivable that the contact sensitized epidermal cells can amplify the immune reactions by stimulating the lynphocytes which are infiltrated in contact sensitized epidermis.
Animals ; Complement System Proteins ; Dermatitis, Allergic Contact ; Epidermis ; Histocompatibility Antigens Class II ; Hypersensitivity, Delayed ; Keratinocytes ; Langerhans Cells ; Lymphocytes ; Mice*

PURPOSE: Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) have been linked to the angiogenic process in general. In order to understand the potential roles of MMPs and TIMPs in corneal neovascularization process, we examined the expression and activities of MMP-2, MMP-9, TIMP-1 and TIMP-2 during the course of suture-induced corneal neovascularization in rat model. METHODS: Corneal neovascularization of rat cornea was induced by suturing. The expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in sutured corneas was examined by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The activities of MMP-2 and MMP-9 were measured before and after suture by gelatin zymography. RESULTS: MMP-2 proenzyme, and TIMP-1, -2 were expressed in normal corneas, predominantly in corneal epithelium. After injury, expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 increased, notably in healing corneal epithelium, infiltrating inflammatory cells, stromal fibroblasts, and ingrowing vascular endothelial cells. The intensity of immunostaining and enzymatic activities of MMP-2 and MMP-9 paralleled the magnitude of inflammatory cell infiltration, which peaked around day 7 after suture. Immunoreactivity of MMP/TIMP decreased significantly two weeks after suturing. At day 35 after suture, staining of MMP-2, TIMP-1, -2 remained visible only in corneal epithelium and vascular endothelial cells. CONCLUSIONS: MMPs as well as TIMPs were upregulated during suture-induced corneal neo-vascularization, suggesting that both may take part in extracellular matrix remodeling in the corneal wound healing, inflammatory, and neovascularization processes.
Animals ; Cornea ; Corneal Neovascularization* ; Endothelial Cells ; Epithelium, Corneal ; Extracellular Matrix ; Fibroblasts ; Gelatin ; Immunohistochemistry ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Metalloproteases ; Models, Animal ; Rats ; Stromal Cells ; Sutures ; Tissue Inhibitor of Metalloproteinase-1* ; Tissue Inhibitor of Metalloproteinase-2 ; Wound Healing

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*

BACKGROUND: Recently, it is substituted automatic sphygmomanometer for mercury sphygmomanometer. But it seems to be insufficient for data of its accuracy. A sample accurate automatic sphygmomanometer could have an important role in the management of hypertension. The aim of this study is to assess the accuracy of the automatic sphygmomanometer that is used common practice and at home. METHODS: We collected 247 patients who visited the department of Famiiy Practice of Taegu medical center from April to August 1996. BP was measured sequentially same arm by standard device(mercury. sphygmomanometer), test device A(A&D TM-2650), test device B(seine SE-2000). We assessed the automatic sphygmomanometer according to the standards set out by the British Hypertension Society(BHS) protocol and the American Association for the Advancement of Medical Instrumentation(AAMI). These data were analysed using pearson' correlation and paired t-test. RESULTS: Test device A was highly correlated to mercury sphygmomanometer in systolic and diastolic BP(r=0.90, r=0.88). Also test device B was highly correlated to that(r=0.90, r=0.87). The mean difference between BP value obtained by the standard device and those obtained by the test device A were 0.59+/-7.66mmHg systole(mean+/-SD) and 3.83+/-6.43mmHg diast.ole, whereas the difference between the former and those obtained by the test device B were 1.70+/-7.99mmHg systole.and 5.58+/-6.38mmHg diastole. Comparing to standard device, there were a signifioant difference except systolic BP of test device A(P<0.05). According to the criteria of the AAMI, the diastolic BP of test device B was not enough and according to the criteria of the BHS, the diastolic BP of both test device were not enough. CONCLUSIONS: Both test device were highly correlated to mercury sphygmomanometer. But according to the criteria of the BHS and AAMI, there were not enough. Because the use of automatic sphygmomanometer was popularized, I think that further study will be required to assess of accuracy.
Arm ; Blood Pressure* ; Daegu ; Diastole ; Humans ; Hypertension ; Sphygmomanometers*

No abstract available.
Humans

No abstract available.
Titanium*

Two cases of Bleeding Meckel's Diverticulum Using (99m)Technetium-Pertechnetate Scanning are presented. (99m)TC-pertechnetate was used in the diagnosis of Meckel's Diverticulum by Jewette et al in 1970 for the first time. The affinity of this isotope for the parietal cell of the gastric mucosa makes it ideal for delincating ectopic gastric tissue. It noninvasiveness can be used in early screening test of occult gastrointestinal bleeding in pediatric age group.
Diagnosis* ; Gastric Mucosa ; Hemorrhage* ; Humans ; Mass Screening ; Meckel Diverticulum* ; Rabeprazole ; Sodium Pertechnetate Tc 99m*

Magnetic resonance (MR) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. MRI is conceptually quite different from currently used imaging methods. The complex nature of MRI allows a great deal of flexibility in image production and available information, and key points are as follows. 1. MR offers a non-invasive technique with which to generate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of MRI is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of MRI 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fastening scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen. e. Further development of contrast media f. MR in vivo spectroscopy g. Real time MR imaging
Comprehension* ; Contrast Media ; Diagnostic Imaging ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Pliability ; Radiation, Ionizing ; Spectrum Analysis